In October 2024, the global stockpile of oral cholera vaccine (OCV) ran dry yet again, leaving no unallocated doses for new or worsening outbreaks. This underscores the ongoing shortfall of tens of millions of doses, driven by growing need, with both cases and deaths increasing globally in recent years, and lack of supply, with only one manufacturer currently serving the global stockpile. Meanwhile, however, pharmaceutical companies are reaping profits from a booming parallel market for OCV for a much lower-risk population: travelers from high-income countries (HICs). The current situation, where a tourist from a HIC at essentially zero risk of dying from cholera has more ready access to vaccines than a resident of the endemic country they will visit, exemplifies the chasm between commercial priorities and global health needs.